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DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes
Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices includin...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ivyspring International Publisher
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604195/ https://www.ncbi.nlm.nih.gov/pubmed/28928852 http://dx.doi.org/10.7150/jca.20871 |
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author | Kuerer, Henry M. Smith, Benjamin D. Chavez-MacGregor, Mariana Albarracin, Constance Barcenas, Carlos H. Santiago, Lumarie Edgerton, Mary E. Rauch, Gaiane M. Giordano, Sharon H. Sahin, Aysegul Krishnamurthy, Savitri Woodward, Wendy Tripathy, Debasish Yang, Wei T. Hunt, Kelly K. |
author_facet | Kuerer, Henry M. Smith, Benjamin D. Chavez-MacGregor, Mariana Albarracin, Constance Barcenas, Carlos H. Santiago, Lumarie Edgerton, Mary E. Rauch, Gaiane M. Giordano, Sharon H. Sahin, Aysegul Krishnamurthy, Savitri Woodward, Wendy Tripathy, Debasish Yang, Wei T. Hunt, Kelly K. |
author_sort | Kuerer, Henry M. |
collection | PubMed |
description | Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS. Use of these protocols over the past 20-years has resulted in 10-year local recurrence rates below 5% for patients with negative margins < 2 mm who received RT. Patients with margins < 2 mm who do not receive RT experience significantly higher local failure rates. Thus, there is not an absolute need to achieve wider negative surgical margins when < 2 mm for patients treated with RT and this should be determined by the multidisciplinary team. Utilization of these multidisciplinary treatment protocols and techniques may not be exportable and extrapolated to all hospitals, breast programs and systems as they can be complex and resource intensive. |
format | Online Article Text |
id | pubmed-5604195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Ivyspring International Publisher |
record_format | MEDLINE/PubMed |
spelling | pubmed-56041952017-09-19 DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes Kuerer, Henry M. Smith, Benjamin D. Chavez-MacGregor, Mariana Albarracin, Constance Barcenas, Carlos H. Santiago, Lumarie Edgerton, Mary E. Rauch, Gaiane M. Giordano, Sharon H. Sahin, Aysegul Krishnamurthy, Savitri Woodward, Wendy Tripathy, Debasish Yang, Wei T. Hunt, Kelly K. J Cancer Review Recent published guidelines suggest that adequate margins for DCIS should be ≥ 2 mm after breast conserving surgery followed by radiotherapy (RT). Many groups now use this guideline as an absolute indication for additional surgery. This article describes detailed multidisciplinary practices including extensive preoperative/intraoperative pathologic/histologic image-guided assessment of margins, offering some patients with small low/intermediate grade DCIS no RT, the use/magnitude of radiation boost tailoring to margin width, and endocrine therapy for ER-positive DCIS. Use of these protocols over the past 20-years has resulted in 10-year local recurrence rates below 5% for patients with negative margins < 2 mm who received RT. Patients with margins < 2 mm who do not receive RT experience significantly higher local failure rates. Thus, there is not an absolute need to achieve wider negative surgical margins when < 2 mm for patients treated with RT and this should be determined by the multidisciplinary team. Utilization of these multidisciplinary treatment protocols and techniques may not be exportable and extrapolated to all hospitals, breast programs and systems as they can be complex and resource intensive. Ivyspring International Publisher 2017-08-22 /pmc/articles/PMC5604195/ /pubmed/28928852 http://dx.doi.org/10.7150/jca.20871 Text en © Ivyspring International Publisher This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions. |
spellingShingle | Review Kuerer, Henry M. Smith, Benjamin D. Chavez-MacGregor, Mariana Albarracin, Constance Barcenas, Carlos H. Santiago, Lumarie Edgerton, Mary E. Rauch, Gaiane M. Giordano, Sharon H. Sahin, Aysegul Krishnamurthy, Savitri Woodward, Wendy Tripathy, Debasish Yang, Wei T. Hunt, Kelly K. DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title | DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title_full | DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title_fullStr | DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title_full_unstemmed | DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title_short | DCIS Margins and Breast Conservation: MD Anderson Cancer Center Multidisciplinary Practice Guidelines and Outcomes |
title_sort | dcis margins and breast conservation: md anderson cancer center multidisciplinary practice guidelines and outcomes |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604195/ https://www.ncbi.nlm.nih.gov/pubmed/28928852 http://dx.doi.org/10.7150/jca.20871 |
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